Radiographs

Why does my child need X-rays?

Radiographic or X-ray examinations provides the dentist with an important tool that shows the condition of your child's teeth, their roots, jaw placement, and the overall composition of facial bones. X-rays can help determine the presence or degree of dental decay , periodontal disease, abscesses, and many abnormal growths, such as cysts and tumors. X- rays also can show the exact location of impacted and un-erupted teeth. They can pinpoint the location of cavities and other signs of disease that may not be possible to detect through a visual examination. It also allows the dentist to monitor small lesions or other pathology over a period of time.

Most children under the age of 6 usually only need 2 bitewing radiographs and one (anterior teeth) radiograph. However, if more complex dental disease is present then additional radiographs may be necessary to completely evaluate the condition.
Below are examples of a bitewing x-rays and an occlusal x-ray. The bitewing allows the dentist to see cavities between the teeth, which may be difficult to locate during an exam. The occlusal x-ray below shows the presence of an extra tooth.

When do children first receive dental x-rays?

Once children's back teeth are touching together it is important to attempt radiographs. Usually this is around 2-3 years old if no other conditions or concerns are present. The required radiographs are 2 bitewing radiographs. The child simply bites down on a this piece of paper or plastic stick for 3 seconds and the radiograph is done.

When I take my x-rays at my dentist I have a hard time. Sometimes the film hurts the roof or floor of my mouth or sets off my gag reflex. Will my child have to deal with that problem as well?

No. At Dr. Malcolm's office everything is designed for kids. The film used is not firm. Instead it is very thin and flexible. In addition, the film length is significantly shorter and gagging is not a huge issue. Dr. Malcolm's staff is very trained in obtaining good x-rays quickly and efficiently. More often than not, even children with a strong gag reflex are able to do their x-rays with minimal problems. The staff is very good at teaching the children the proper technique for obtaining their x-rays. Of course, not every child can get it the first time and sometimes more assistance is needed to help the children obtain their x-rays. In those instances where the child is not able to cooperate, then the radiographs can be post-poned until next visit.

Is it less important to get radiographs in children since their teeth will fall out anyway?

No. On the contrary, decay in baby teeth progresses much faster versus decay in permanent teeth. Baby teeth have thinner enamel and the nerve is located much closer to the outer surfaces of the teeth. Thus, if small cavities are not detected early, particularly in between teeth that the dentist cannot visualize, it is more likely that more complicated procedures will have to be performed later once the cavity progresses. As a result, Dr. Malcolm and his staff place a great priority of obtaining the necessary x-rays so that less procedures will be needed later. Ultimately this will save the parent money and mean less time in the dental chair for your child.

Do all patients have radiographs taken every six months?

No. Your radiographic schedule is based on the dentist's assessment of your child's individual needs, cavity risk, age, dietary assessment and overall hygiene of the child. Children that are at a higher risk for dental disease need more radiographic assessment than other children who are at less risk.

My dentist has prescribed a "panoramic radiograph." What is that and how does it differ from the X-rays I usually have?

Just as a panoramic photograph allows you to see a broad vista such as the Grand Canyon, a panoramic radiograph allows your dentist to see the entire structure of your child's mouth in a single image. The panoramic x-ray allows the dentist to view numerous things such as: presence of extra teeth, missing teeth, crowding, eruption pattern, cysts, wisdom teeth, development of roots, expectation of tooth loss, and so on. Typically, most dental patients have "periodical" or "bitewing" radiographs taken. These require patients to hold or bite down on a piece of plastic with X-ray film in the center. Bitewings typically determine the presence of decay in between teeth, while periodical X-rays show root structure, bone levels, cysts and abscesses. Below are examples of panoramic x-rays. The x-ray on the left shows impacted teeth while the one on the right shows a patient with missing teeth.

Why do I need both types of X-rays?

What's apparent through one type of X- ray often is not visible on another. The panoramic X-ray will give your dentist a general and comprehensive view of your entire mouth on a single film, which a periodical X-ray cannot show. On the other hand, periodical or bitewing X-rays show a highly-detailed image of a smaller area, making it easier to see decay or cavities between your teeth. Radiographs are not prescribed indiscriminately. Your dentist has a need for the different information that each radiograph can provide to formulate a diagnosis.

Should I be concerned about exposure to radiation?

All health care providers are sensitive to patients' concerns about exposure to radiation. Your dentist has been trained to prescribe radiographs when they're appropriate and to tailor radiographic schedules to each patient's individual needs. By using state-of-the-art technology and by staying knowledgeable about recent advances, your dentist knows which techniques, procedures and X-ray films can minimize your exposure to radiation.

Dr. Malcolm's office uses digital radiography and fast-exposure film, thus reducing the exposure of radiation to a minimum (usually 60-75% less than traditional films). In fact, if it is a sunny day, more radiation is probably received by the child on the way to the office if the sun is shining on the child.

What if my dental insurance plan does not allow reimbursement for the additional X-ray?

It's wise for all patients to know the limitations or restrictions of their dental benefits plan. To control their own costs, some insurance plans limit reimbursement to a single type of radiographic survey. Occasionally they will allow coverage for additional radiographs, providing that your dentist supplies them with adequate information demonstrating why the additional radiographs are necessary. Nevertheless, X-rays should be taken based on need, regardless of whether or not they are covered by your dental benefits plan. If your dental benefits policy restricts coverage to one type of X-ray, consider writing your plan purchaser(usually someone in your Personnel or Benefits department).